Name:____________________________________________ Provider:________________________________ Date:_____________________________________________ Time:___________________________________

Name:____________________________________________ Provider:________________________________
Date:_____________________________________________ Time:___________________________________
NON-EXERCISE / LEXISCAN NUCLEAR STRESS TEST
A Lexiscan nuclear test is a non-invasive, non-exercising stress test. Pre and post scans will be done in order to
evaluate the perfusion of your heart muscle from the coronary arteries. This test is done in three parts and will not
require any walking. The test will take 3 to 4 hours.
Procedure:
• The technologist will start an IV in your arm or hand
• You will be given an injection of a radioactive material through the IV.
• You will lie on your back on the imaging table.
• Images will be taken of your heart with a special camera. This will take about 25 minutes. You must lie still
during the images.
• You will go to the stress lab for the stress portion of the exam. The stress tech will place ECG patches on
your chest and a blood pressure cuff on your arm. These will be used to monitor you during the exam.
• You will get an injection of Lexiscan and a radioactive material through the IV.
• When the Lexiscan portion of the test is completed, your IV will be taken out.
• After the stress test, a second set of pictures will be taken of your heart in the nuclear imaging room. The
images will take about 15 to 20 minutes. You must lie still during the images.
Instruction checklist for the Stress Test:
1.
2.
Please take all of your scheduled medications on that day, unless directed by your provider. Your
physician may also ask you to stop taking other heart medications on the day of your test. If you have
any questions about your medications, ask your physician. Do not discontinue any medication
without first talking to your physician.
Do not eat (chocolate) or drink foods containing CAFFEINE for 24 hours prior to the test (this includes
some headache medications). Products labeled decaffeinated and caffeine-free contain trace amounts of
caffeine and should be avoided. Caffeine will interfere with the results of your test. If you have had
caffeine products within 24 hours of your test, you will be rescheduled.
•
It’s okay to drink small amounts of water prior to the test.
•
You may have a light meal up to 4 hours BEFORE your test.
3.
Wear comfortable clothing and athletic/rubber soled shoes. Pants or shorts and short sleeve shirts are
preferred. Do not wear one-piece garments or body suits.
4.
Do not apply any after shave, creams, lotions, or powder to your chest and neck area on the day of your
test. You may wear deodorant.
5.
If you have a history of wheezing, asthma, chronic lung disease, or take Theophylline or
Aminophylline type medications, please inform the technician and if applicable, bring your inhaler to
your appointment.
6.
Do not smoke 24 hours prior to the test.
7.
Diabetic patients: If you are on insulin or oral hypoglycemic medications, eat a light snack 2 hours
before your appointment and TAKE your diabetic medications.
Cancelation Policy:
Please contact us 24 hours prior if you are unable to make your appointment. If you do not show for your
scheduled appointment you will be responsible for a $75 service charge for the medication.
BETA BLOCKERS
BRAND NAMES
GENERIC NAMES
Betapace
Sotalol
Blocadren
Timolol
Brevibloc
Esmolol
Bystolic
Nebivolol
Cartrol
Carteolol
Coreg
Carvedilol
Corgard
Nadolol
Corzide
Nadolol / Bendroflumethiazide
Inderal
Propranolol
Inderide
Propranolol / HCTZ
Kerlone
Betaxolol
Levatol
Penbutolol
Lopressor HCT
Metoprolol / HCTZ
Lopressor
Metoprolol
Normodyne
Labetalol
Sectral
Acebutolol
Tenoretic
Atenolol / Chlorthalidone
Tenormin
Atenolol
Timolide
Metoprolol
Trandate
Labetalol
Visken
Pindolol
Zebeta
Bisoprolol
Lopressor
Toprol
Ziac
Bisoprolol Fumarate & HCTZ